Postoperative Complications of Laparoscopic Total Gastrectomy versus Open Total Gastrectomy for Gastric Cancer in a Meta-Analysis of High-Quality Case-Controlled Studies

Background. Some meta-analyses of case-controlled studies (CCSs) have shown that laparoscopic or laparoscopy-assisted total gastrectomy (LTG) had some short-term advantages over open total gastrectomy (OTG). However, postoperative complications differed somewhat among the meta-analyses, and some CCSs included in the meta-analyses had mismatched factors between LTG and OTG. Methods. CCSs comparing postoperative complications between LTG and OTG were identified in PubMed and Embase. Studies matched for patients’ status, tumor stage, and the extents of lymph-node dissection were included. Outcomes of interest, such as anastomotic, other intra-abdominal, wound, and pulmonary complications, were evaluated in a meta-analysis performed using Review Manager version 5.3 software. Result. This meta-analysis included a total of 2,560 patients (LTG, 1,073 patients; OTG, 1,487 patients) from 15 CCSs. Wound complications were significantly less frequent in LTG than in OTG (n = 2,430; odds ratio [OR] 0.30, 95% confidence interval [CI] 0.29–0.85, P=0.01, I2 = 0%, and OR 0.46, 95% CI 0.17–0.52, P<0.0001, I2 = 0%). However, the incidence of anastomotic complications was slightly but not significantly higher in LTG than in OTG (n = 2,560; OR 1.44, 95% CI 0.96–2.16, P=0.08, I2 = 0%). Conclusion. LTG was associated with a lower incidence of wound-related postoperative complications than was OTG in this meta-analysis of CCSs; however, some concern remains about anastomotic problems associated with LTG.

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“Smoking paradox” is not true in patients with ischemic stroke: a systematic review and meta-analysis

Journal of Neurology ◽

10.1007/s00415-019-09596-3 ◽

2019 ◽

Author(s):

Bo Li ◽

Dan Li ◽

Jing-Feng Liu ◽

Lin Wang ◽

Bao-Zhu Li ◽

...

Keyword(s):

Ischemic Stroke ◽

Protective Factor ◽

Meta Analysis ◽

Vascular Diseases ◽

Cochrane Library ◽

Inverse Variance ◽

First Onset ◽

Prognostic Outcome ◽

Meta Analyses ◽

Review Manager

Abstract Background Ischemic stroke (IS) is a common cause of death from vascular diseases. Studies have found that smoking increases the risk of ischemic stroke, but the association of smoking with the outcome of IS remains unclear. This meta-analysis aims to investigate the effect of smoking on the prognosis of IS. Methods We searched four electronic databases including PubMed, EMBASE, Cochrane library and Web of science for papers, published before January 2019. In this meta-analysis, Review Manager 5.3 software was used to calculate for the pooled estimate effect, as well as the inverse-variance method for pooled mean difference (MD) and odds ratio (OR) of incidence in two groups of population. Results A total of 14,789 citations were identified during the literature search, 21 studies were included in the meta-analyses after screening. The full-adjusted OR of poor prognostic outcome in smoking and nonsmoking patients with stroke was pooled as 0.96 (95% CI 0.77–1.21), suggested that smoking or not has no impact on prognosis of IS. The pooled MD of onset age between smoking and nonsmoking IS patients was − 10.05 (− 12.91, − 7.19), indicated that smoking causes first onset of IS to occur 10 years earlier. Conclusions This meta-analysis showed that smoking was not a protective factor for poor prognosis of IS. Smoking patients with IS are 10 years younger than nonsmoking patients at time of the first onset of stroke.

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ASO Author Reflections: Anastomotic Complications are More Prevalent in Laparoscopic Total Gastrectomy than in Open Total Gastrectomy

Annals of Surgical Oncology ◽

10.1245/s10434-019-07990-9 ◽

2019 ◽

Vol 27 (2) ◽

pp. 527-528

Author(s):

Takashi Sakamoto ◽

Michimasa Fujiogi ◽

Hiroki Matsui ◽

Kiyohide Fushimi ◽

Hideo Yasunaga

Keyword(s):

Total Gastrectomy ◽

Laparoscopic Total Gastrectomy ◽

Anastomotic Complications ◽

Open Total Gastrectomy

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Laparoscopic total gastrectomy versus open total gastrectomy for cancer: a systematic review and meta-analysis

Surgical Endoscopy ◽

10.1007/s00464-012-2661-1 ◽

2012 ◽

Vol 27 (5) ◽

pp. 1509-1520 ◽

Cited By ~ 110

Author(s):

Leonie Haverkamp ◽

Teus J. Weijs ◽

Pieter C. van der Sluis ◽

Ingeborg van der Tweel ◽

Jelle P. Ruurda ◽

...

Keyword(s):

Systematic Review ◽

Total Gastrectomy ◽

Meta Analysis ◽

Laparoscopic Total Gastrectomy ◽

Open Total Gastrectomy

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The choice of dissection or preservation of the inferior pulmonary ligament after an upper lobectomy: a systematic review and meta-analysis

World Journal of Surgical Oncology ◽

10.1186/s12957-019-1777-3 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Hao Lv ◽

Rui Zhou ◽

Xianghong Zhan ◽

Dongmei Di ◽

Yongxian Qian ◽

...

Keyword(s):

Systematic Review ◽

Postoperative Complications ◽

Meta Analysis ◽

The Other ◽

Cochrane Library ◽

Drainage Time ◽

Significant Difference ◽

The Right ◽

Group D ◽

Review Manager

Abstract Background The necessity of the inferior pulmonary ligament (IPL) dissection after an upper lobectomy remains controversial. This meta-analysis aimed to evaluate whether this accessional procedure could reduce the postoperative complications and improve outcomes. Methods PubMed, Embase, Ovid, Cochrane Library, CBM, and CNKI databases were searched for the relevant studies which compared the dissection with preservation of IPL during the upper lobectomy. The Review Manager 5.3 software was used for this meta-analysis. Results Three RCTs and five CCTs were included in this meta-analysis. These studies contained a total of 610 patients, in which 315 patients received a pulmonary ligament dissection (group D) after the upper lobectomy, while the other 295 patients preserved the pulmonary ligament (group P). No significant difference was demonstrated between the group D and group P in terms of drainage time after surgery (MD 0.14, 95%CI − 0.05 to 0.33, P = 0.15), rate of postoperative dead space (OR 1.33, 95%CI 0.72 to 2.46, P = 0.36), rate of postoperative complications (OR 1.20, 95%CI 0.66 to 2.19, P = 0.56). However, the pooled comparison revealed a greater change of the right main bronchial angle (MD 5.00, 95%CI 1.68 to 8.33, P = 0.003) in group D compared with group P, indicated that the dissection of IPL may lead to a greater distortion of bronchus. Conclusions This meta-analysis confirmed that the dissection of IPL do not effectively reduce the postoperative complications and improve the prognosis. Therefore, it is not necessary to dissect the IPL after an upper lobectomy.

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Preoperative opioid use and complications following total joint replacement: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-035377 ◽

2020 ◽

Vol 10 (6) ◽

pp. e035377

Author(s):

Cade Shadbolt ◽

Daniel Gould ◽

Ximena Camacho ◽

Josh Knight ◽

Siddharth Rele ◽

...

Keyword(s):

Systematic Review ◽

Postoperative Complications ◽

Joint Replacement ◽

Total Joint Replacement ◽

Meta Analysis ◽

Experimental Studies ◽

Assessment Tools ◽

Study Quality ◽

Opioid Use ◽

Meta Analyses

IntroductionMounting evidence now indicates that preoperative opioid use is associated with an array of complications following total joint replacement (TJR). However, evidence of these risks remains fragmented. A comprehensive and well-integrated understanding of this body of evidence is necessary to appropriately inform treatment decisions, the allocation of limited healthcare resources, and the direction of future clinical research. The proposed systematic review and meta-analysis aims to identify and synthesise the available evidence of an association between opioid use prior to TJR and postoperative complications, categorised by complication type.Methods and analysisWe will search MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science from inception to April 2020. Observational and experimental studies that compare preoperative opioid users who have undergone elective TJR to opioid naïve TJR patients will be included. The primary outcomes will be postoperative complications, which will be categorised as either mortality, morbidity, or joint-related complications. The secondary outcomes will be persistent postoperative opioid use, readmission, and length of stay. Individual study quality will be assessed using the relevant NIH–NHLBI study quality assessment tools. Findings will be reported in narrative and tabular form, and, where possible, odds ratios (dichotomous outcomes) or standardised mean differences (continuous outcomes) will be reported with 95% confidence intervals. Where appropriate, random effect meta-analyses will be conducted for each outcome, and heterogeneity will be quantified using the I2 statistic and Cochran’s Q test. This study will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines.Ethics and disseminationEthics approval will not be required as no primary or private data are being collected. Findings will be disseminated through peer-reviewed publication and presentation at academic conferences.PROSPERO registration numberCRD42020153047.

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Laparoscopy-Assisted Versus Open Total Gastrectomy for Gastric Cancer: A Meta-analysis

Journal of Laparoendoscopic & Advanced Surgical Techniques ◽

10.1089/lap.2013.0152 ◽

2013 ◽

Vol 23 (10) ◽

pp. 832-840 ◽

Cited By ~ 11

Author(s):

Hongliang Shen ◽

Chengxiang Shan ◽

Sheng Liu ◽

Ming Qiu

Keyword(s):

Gastric Cancer ◽

Total Gastrectomy ◽

Meta Analysis ◽

Open Total Gastrectomy

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Impact of spleen-preserving total gastrectomy on postoperative infectious complications and 5-year overall survival: systematic review and meta-analysis of contemporary randomized clinical trials

Current Oncology ◽

10.3747/co.26.4391 ◽

2019 ◽

Vol 26 (2) ◽

Cited By ~ 3

Author(s):

A. Aiolfi ◽

E. Asti ◽

S. Siboni ◽

D. Bernardi ◽

E. Rausa ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Total Gastrectomy ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Reoperation Rate ◽

Infectious Complications ◽

Hospital Length Of Stay ◽

Spleen Preserving ◽

Open Total Gastrectomy

Background The role of splenectomy in proximal gastric cancer is still debated. The objective of the present metaanalysis was to provide more-robust evidence about the effect of spleen-preserving total gastrectomy on postoperative infectious complications, overall morbidity, and 5-year overall survival (os).Methods PubMed, embase, and the Web of Science were consulted . Pooled effect measures were calculated using an inverse-variance weighted or Mantel–Haenszel in random effects meta-analysis. Heterogeneity was evaluated using I2 index and Cochran Q-test.Results Three randomized controlled trials published between 2000 and 2018 were included. Overall, 451 patients (50.1%) underwent open total gastrectomy with spleen preservation and 448 (49.9%) underwent open total gastrectomy with splenectomy. The patients ranged in age from 24 to 78 years. No differences were found in the number of harvested lymph nodes (p = 0.317), the reoperation rate (p = 0.871), or hospital length of stay (p = 0.347). The estimated pooled risk ratios for infectious complications, overall morbidity, and mortality were 1.53 [95% confidence interval (ci): 1.09 to 2.14; p = 0.016], 1.51 (95% ci: 1.11 to 2.05; p = 0.008), and 1.23 (95% ci: 0.40 to 3.71; p = 0.719) respectively. The estimated pooled hazard ratio for 5-year os was 1.06 (95% ci: 0.78 to 1.45; p = 0.707).Conclusions Spleen-preserving total gastrectomy should be considered in patients with curable gastric cancer because it is significantly associated with decreased postoperative infectious complications and overall morbidity, with no difference in the 5-year os. Those observations appear worthwhile for establishing better evidence-based treatment for gastric cancer.

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Laparoscopic versus open total gastrectomy with D2 dissection for gastric cancer: a meta-analysis

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-013-1462-9 ◽

2013 ◽

Vol 139 (10) ◽

pp. 1721-1734 ◽

Cited By ~ 21

Author(s):

Weizhi Wang ◽

Zheng Li ◽

Jie Tang ◽

Meilin Wang ◽

Baolin Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Total Gastrectomy ◽

Meta Analysis ◽

D2 Dissection ◽

Open Total Gastrectomy

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Antiphospholipid Antibody and Recurrent Ischemic Stroke

Stroke ◽

10.1161/strokeaha.120.030431 ◽

2020 ◽

Vol 51 (12) ◽

pp. 3728-3732

Author(s):

Yerim Kim ◽

Soo Young Kim

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Young Patients ◽

Cochrane Library ◽

Computer Assisted ◽

Antiphospholipid Antibody ◽

Prospective Trials ◽

Meta Analyses ◽

Review Manager

Background and Purpose: Although aPLs (antiphospholipid antibodies) are associated with thrombotic events, especially in young patients, the role of aPLs in recurrent ischemic strokes (RIS) is unclear. This systematic review and meta-analysis evaluated the association between aPLs and RIS. Methods: The systematic review was conducted by a computer-assisted search of literature in PubMed, EMBASE, and Cochrane library published in English or Korean from 1990, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). Review Manager 5.3 software was used for statistical analyses. Results: Of the 2272 identified articles, 8 studies were included (2510 subjects; 844 aPL positive). The meta-analysis revealed a relative risk of aPLs for RIS of 1.41 (95% CI, 0.91–2.17; I 2 =54%). In the subgroup analysis, age <50 years, ethnicity, and type of aPL did not increase the risk of RIS. Conclusions: We found that aPLs are not an independent predictor for RIS in adults. However, considering the nonstandardized disease criteria, further well-designed prospective trials should be considered to confirm these findings.

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